Salokorpi Niina, Sinikumpu Juha-Jaakko, Iber Tarja, Zibo Heleia Nestal, Areda Tarmo, Ylikontiola Leena, Sándor George K, Serlo Willy
PEDEGO Research Center and Medical Research Center Oulu, University of Oulu, Oulu, Finland,
Childs Nerv Syst. 2015 Jul;31(7):1121-8. doi: 10.1007/s00381-015-2657-y. Epub 2015 Feb 26.
Premature ossification of coronal and metopic sutures is treated by fronto-orbital remodeling. Such operations require stable fixation of the reshaped cranial bones. Currently, biodegradable plating systems are used to provide sufficient stability over the time that takes for the osteotomies to ossify. Plates that are placed traditionally on the outer surface of the cranium are often palpable and even visible through the thin overlying skin, compromising the cosmetic results of these operations. Improved aesthetics could be achieved by placing the plates endocranially.
This study aimed to evaluate endocranial resorbable plate fixation and its clinical and radiographic results in frontal remodeling cranioplasty for plagiocephaly and trigonocephaly patients with follow-up sufficiently long for the plates to have been completely resorbed.
A poly(lactide-co-glycolide) (PLGA) resorbable plating system was used on the inner aspect of frontal bone in 27 patients treated for coronal and metopic craniosynostoses. The outcome was evaluated at follow-up visits. The mean follow-up was 79.2 months.
Three patients had complications that required reoperations. None of these complications were related to the endocranial location of the plates. There were no problems with ossification of the osteotomy sites. All but one patient's outcome was judged as good or excellent.
Placement of resorbable fixation on the endocranial surface of the calvarial bones is safe, stable, and results in satisfactory aesthetics without interfering with the ossification of the cranial bones.
冠状缝和额缝过早骨化通过额眶重塑进行治疗。此类手术需要对重塑的颅骨进行稳定固定。目前，可生物降解的接骨板系统用于在截骨部位骨化所需的时间内提供足够的稳定性。传统上放置在颅骨外表面的接骨板通常可以摸到，甚至透过薄薄的覆盖皮肤可见，影响了这些手术的美容效果。通过将接骨板置于颅内可改善美观。
本研究旨在评估颅内可吸收接骨板固定及其在斜头畸形和三角头畸形患者额部重塑颅骨成形术中的临床和影像学结果，随访时间足够长，以使接骨板完全吸收。
27例因冠状缝和额缝早闭接受治疗的患者在额骨内侧面使用了聚丙交酯-乙交酯（PLGA）可吸收接骨板系统。在随访时评估结果。平均随访时间为79.2个月。
3例患者出现需要再次手术的并发症。这些并发症均与接骨板的颅内位置无关。截骨部位没有骨化问题。除1例患者外，所有患者的结果均被判定为良好或优秀。
在颅盖骨的颅内表面放置可吸收固定装置是安全、稳定的，并且在不干扰颅骨骨化的情况下可产生令人满意的美观效果。
